| NPI | 1104563824 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHINYERE ADIBE Provider 202-390-4129 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2022-05-14 |
| Last Update Date | 2023-02-06 |